Bitter experience helps French ICUs crest latest virus wave

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A nurse tends to a patient affected by the COVID-19 virus in the ICU unit at the Charles Nicolle public hospital, Thursday, April 15, 2021 in Rouen, France. A renewed crush of COVID-19 cases is again forcing intensive care units across France to grapple with the macabre mathematics of how to make space for thousands of critically ill patients (AP Photo/Christophe Ena)

ROUEN – Slowly suffocating in a French intensive care ward, Patrick Aricique feared he would die from his diseased lungs that felt “completely burned from the inside, burned like the cathedral in Paris,” as tired doctors and nurses labored day and night to keep gravely ill COVID-19 patients like him alive.

A married couple in the same ICU died within hours of each other as Aricique, feeling as fragile as “a soap bubble ready to pop," also wrestled the coronavirus. The 67-year-old retired building contractor credits a divine hand for his survival. “I saw archangels, I saw little cherubs,” he said. “It was like communicating with the afterlife.”

On his side were French medical professionals who, forged on the bitter experiences of previous infection waves, now fight relentlessly to keep patients awake and off mechanical ventilators, if at all possible. They treated Aricique with nasal tubes and a mask that bathed his heaving lungs in a constant flow of oxygen. That spared him the discomfort of a thick ventilation tube deep down his throat and heavy sedation from which patients often fear — sometimes, rightly so — that they will never awake.

While mechanical ventilation is unavoidable for some patients, it’s a step taken less systematically now than at the start of the pandemic. Dr. Philippe Gouin, who heads the ICU ward where Aricique underwent treatment for severe COVID-19, said, “We know that every tube we insert is going to bring its share of complications, extensions in stay, and sometimes morbidity."

About 15% to 20% of his intubated patients don't survive, he said.

“It's a milestone that weighs on survival," Gouin said. ”We know that we will lose a certain number of patients who we won’t be able to help negotiate this corner."

The shift to less-invasive breathing treatments also is helping French ICUs stave off collapse under a renewed crush of coronavirus cases. Super-charged by a more contagious virus variant that first ravaged neighboring Britain, the third infection wave in France has pushed the country's COVID-19-related death toll past 100,000 people. Hospitals across the country are grappling again with the macabre mathematics of making space for thousands of critically sick patients.

“We have a continuous flow of cases,” said Dr. Philippe Montravers, an ICU chief at Bichat Hospital in Paris, which is again shoe-horning patients into makeshift critical care units. “Each of these cases are absolutely terrible stories — for the families, for the patients themselves, of course, for the physicians in charge, for the nurses.”